Journal of Nippon Medical School最新文献

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Microtia with coexistent large external auditory canal cholesteatoma: a case report. 小耳畸形合并大外耳道胆脂瘤1例。
IF 1.2 4区 医学
Journal of Nippon Medical School Pub Date : 2025-03-22 DOI: 10.1272/jnms.JNMS.2025_92-608
Takeshi Matsunobu, Hirotaka Suzuki, Naoko Sakuma, Ryuji Ohashi, Kimihiro Okuobo
{"title":"Microtia with coexistent large external auditory canal cholesteatoma: a case report.","authors":"Takeshi Matsunobu, Hirotaka Suzuki, Naoko Sakuma, Ryuji Ohashi, Kimihiro Okuobo","doi":"10.1272/jnms.JNMS.2025_92-608","DOIUrl":"https://doi.org/10.1272/jnms.JNMS.2025_92-608","url":null,"abstract":"<p><p>Microtia is a congenital disorder characterized by an anomaly in the auricle. It is often associated with atresia, stenosis, or obstruction of the external auditory canal. In cases of microtia, the incidence of a normal external auditory canal, congenital external auditory canal stenosis, and congenital complete closure of the external auditory canal (aural atresia) is reported to be 8%, 8%, and 84%, respectively. Congenital stenosis of the external auditory canal can sometimes be accompanied by intractable otorrhea and otalgia, raising the possibility of complications of external auditory canal cholesteatoma. Here, we report a case of an adult with microtia and external auditory canal stenosis who presented to our clinic with complaints of otalgia. A large external auditory canal cholesteatoma was found in the patient's left ear. Although cholesteatoma is common in cases of canal stenosis, its extensive spread within the temporal bone is quite rare. A temporal bone-targeted computed tomography scan revealed a soft tissue shadow in the left external auditory canal with distensible expansion and bony destruction in the upper, anterior, and posterior walls of the external auditory canal. In patients with microtia who experience severe aural pain, the possibility of latent extended cholesteatoma should be considered.</p>","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Use of Sialendoscopy to Diagnose Sialodochitis Fibrinosa: A Case Report. 用鼻内窥镜诊断纤维性涎腺支气管炎1例。
IF 1.2 4区 医学
Journal of Nippon Medical School Pub Date : 2025-03-22 DOI: 10.1272/jnms.JNMS.2025_92-603
Takeshi Matsunobu, Hirotaka Suzuki, Akira Shimizu, Koji Sakamoto, Kimihiro Okubo
{"title":"Use of Sialendoscopy to Diagnose Sialodochitis Fibrinosa: A Case Report.","authors":"Takeshi Matsunobu, Hirotaka Suzuki, Akira Shimizu, Koji Sakamoto, Kimihiro Okubo","doi":"10.1272/jnms.JNMS.2025_92-603","DOIUrl":"https://doi.org/10.1272/jnms.JNMS.2025_92-603","url":null,"abstract":"<p><p>First reported by Kussmaul in 1879, sialodochitis fibrinosa is a disease of the parotid and/or submandibular glands that is characterized by pain and diffuse swelling. It is believed to be caused by obstruction of the salivary duct by mucofibrinous plugs and is often misdiagnosed as other types of sialadenitis, such as Sjögren' s syndrome, or sialadenitis caused by bacterial or viral infection. Although specific diagnostic criteria have not been defined, the typical pathological finding of sialodochitis fibrinosa is infiltration of lymphocytes and eosinophils into the interstitium around the salivary ducts. Sialendoscopy, a minimally invasive endoscopic technique, has recently been used to diagnose and treat diseases of the salivary glands. This new technique can be used to irrigate and dilate the salivary gland ducts under direct vision. We successfully used sialendoscopy to diagnose and treat sialodochitis fibrinosa, making this the first reported use of this technique for salivary gland biopsies. Sialendoscopy is a modern approach to salivary gland disorders that was helpful for understanding, diagnosing, and managing sialodochitis fibrinosa.</p>","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Vagal Reflex-Induced Asystole During Suspension Laryngoscopy: A Rare Complication. 悬吊喉镜检查时迷走神经反射引起的心脏收缩:一种罕见的并发症。
IF 1.2 4区 医学
Journal of Nippon Medical School Pub Date : 2025-03-22 DOI: 10.1272/jnms.JNMS.2025_92-604
Takeshi Matsunobu, Kimihiro Okubo, Koichiro Saito
{"title":"Vagal Reflex-Induced Asystole During Suspension Laryngoscopy: A Rare Complication.","authors":"Takeshi Matsunobu, Kimihiro Okubo, Koichiro Saito","doi":"10.1272/jnms.JNMS.2025_92-604","DOIUrl":"https://doi.org/10.1272/jnms.JNMS.2025_92-604","url":null,"abstract":"<p><p>Suspension laryngoscopy is commonly used in diagnostic and operative procedures involving the larynx. This study presents a rare case of asystole during suspension laryngoscopy. A 58-year-old woman with an unremarkable medical history underwent suspension laryngoscopy for a left polypoid vocal cord under general anesthesia. Anesthesia induction and tracheal intubation were performed without complications. However, upon inserting a direct laryngoscope and exposing the larynx, her heart rate gradually decreased and asystole occurred. The direct laryngoscope was immediately removed, and atropine sulfate was injected. Spontaneous circulation was restored after 20 s of asystole. The direct laryngoscope was then re-inserted, and the operation was successfully completed without complications. Asystole was attributed to stimulation of the pharyngolaryngeal mucosa through direct laryngoscope-induced vagal reflex. This case highlights the need for surgeons and anesthesiologists to be aware of this rare but potentially life-threatening complication and emphasizes the importance of vigilant electrocardiography monitoring during direct laryngoscope adjustment.</p>","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Video-Assisted Thoracoscopic Surgery for Catamenial Pneumothorax : A Report of Five Cases Treated by Diaphragm Reefing with and without Chemical Pleurodesis. 电视胸腔镜手术治疗双膜性气胸:附或不附化学胸膜切除术的横膈膜冷冻术5例报告。
IF 1.2 4区 医学
Journal of Nippon Medical School Pub Date : 2025-03-22 DOI: 10.1272/jnms.JNMS.2025_92-607
Hirotoshi Kubokura, Yuuya Tomioka, Junichi Okamoto, Naoyuki Yoshino, Jitsuo Usuda
{"title":"Video-Assisted Thoracoscopic Surgery for Catamenial Pneumothorax : A Report of Five Cases Treated by Diaphragm Reefing with and without Chemical Pleurodesis.","authors":"Hirotoshi Kubokura, Yuuya Tomioka, Junichi Okamoto, Naoyuki Yoshino, Jitsuo Usuda","doi":"10.1272/jnms.JNMS.2025_92-607","DOIUrl":"https://doi.org/10.1272/jnms.JNMS.2025_92-607","url":null,"abstract":"<p><strong>Objectives: </strong>Catamenial pneumothorax (CP), the most common manifestation of thoracic endometriosis syndrome, is a rare form of primary spontaneous pneumothorax that occurs in women of reproductive age. Although CP is usually treated surgically or with hormonal therapy, there is no standard treatment and recurrence is common. We performed video-assisted thoracoscopic surgery (VATS) for five patients with CP from 2014 to 2023.</p><p><strong>Methods: </strong>Our surgical basic procedure (BP) was as follows. VATS was performed by using one port site for the camera and a 5-cm mini-thoracotomy. Perforated holes or blueberry spots were detected on the diaphragm, and lesions were ligated with an endoscopic loop. After reefing by ligation, the diaphragm was covered with a polyglycolic acid sheet. Three methods were used: (A) BP only (one case); (B) BP with tetracycline plus OK432 (two cases); (C) BP with tetracycline (two cases); because the use of OK432 (an anti-cancer agent) was disallowed in 2019 in our Institutional Review Board rules for patients with benign disease.</p><p><strong>Results: </strong>Age ranged from 33 to 45 years (mean. 38.6±5.1 years), and CP occurred on the right side in all cases. Recurrence occurred in only two of the five cases (one case each for procedures B and C).</p><p><strong>Conclusion: </strong>Our procedure (diaphragm reefing by ligation and covering with a polyglycolic acid sheet) was a more convenient and more effective treatment for CP.</p>","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Diagnostic Performance of Advanced Tomosynthesis in Patients with Metal Devices in the Affected Knee: A Case Report. 先进断层扫描对患膝关节金属装置患者的诊断效果:病例报告。
IF 1.2 4区 医学
Journal of Nippon Medical School Pub Date : 2025-03-07 Epub Date: 2024-06-18 DOI: 10.1272/jnms.JNMS.2025_92-101
Yasushi Oshima, Tokifumi Majima
{"title":"Diagnostic Performance of Advanced Tomosynthesis in Patients with Metal Devices in the Affected Knee: A Case Report.","authors":"Yasushi Oshima, Tokifumi Majima","doi":"10.1272/jnms.JNMS.2025_92-101","DOIUrl":"10.1272/jnms.JNMS.2025_92-101","url":null,"abstract":"<p><p>Simple radiography is the most frequently and widely available technology to examine bone pathologies. Computed tomography (CT) can evaluate pathologies more accurately in multiple planes and three dimensions; however, radiation exposure is much higher than with simple radiography. In addition, diagnostic ability is decreased for both technologies when metal devices are present. Tomosynthesis is a radiographic technology used to evaluate tissues quasi-three-dimensionally with less radiation exposure. Tomosynthesis technology was recently upgraded to reduce the effects of metal artifacts. This case report compares examination time, medical expense, image resolution, and radiation exposure for upgraded tomosynthesis, simple radiography, CT, and standard tomosynthesis in three patients with metal devices in the affected knees. Examination times were similar for the imaging technologies. Diagnostic performance was better for upgraded tomosynthesis than for simple radiography and standard tomosynthesis, and similar to that for CT. Moreover, radiation exposure and expense were higher for tomosynthesis than for simple radiography but lower than for CT. These findings suggest that upgraded tomosynthesis is the best method for evaluating bone pathology when metal devices are present and radiation exposure must be limited.</p>","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":" ","pages":"104-110"},"PeriodicalIF":1.2,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141428334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cerebrospinal Fluid Leakage Due to Dural Thinning after Endoscopic Pituitary Tumor Resection. 内窥镜垂体瘤切除术后硬脑膜变薄导致脑脊液漏。
IF 1.2 4区 医学
Journal of Nippon Medical School Pub Date : 2025-03-07 Epub Date: 2024-06-18 DOI: 10.1272/jnms.JNMS.2025_92-102
Shinichiro Teramoto
{"title":"Cerebrospinal Fluid Leakage Due to Dural Thinning after Endoscopic Pituitary Tumor Resection.","authors":"Shinichiro Teramoto","doi":"10.1272/jnms.JNMS.2025_92-102","DOIUrl":"10.1272/jnms.JNMS.2025_92-102","url":null,"abstract":"<p><p>Sellar reconstruction is important for preventing cerebrospinal fluid (CSF) leakage after transsphenoidal pituitary surgery. This report describes how, despite standard sellar reconstruction, CSF exudation resulted from dural thinning at the anterior skull base, outside the intrasellar area manipulated during pituitary tumor resection. A 76-year-old man underwent endoscopic transsphenoidal surgery for a pituitary tumor extending toward the anterior skull base. After opening the sellar floor, intractable bleeding from the anterior intercavernous sinus occurred during bone removal at the anterior skull base. Pseudocapsule-based extracapsular resection was completed after stopping the bleeding. On the 10th postoperative day, the patient developed CSF rhinorrhea complicated by marked pneumocephalus, and emergency endoscopic repair of the CSF leak was performed. CSF leakage originated from the thinned dura at the anterior skull base located outside the intrasellar area manipulated during tumor resection. The thinned dural area at the anterior skull base coincided with the site of intractable bleeding of the anterior intercavernous sinus during bone removal in tumor resection. The thinned anterior skull base dura was covered with fascia, overlaid with fat, and closed with the nasoseptal flap. Endoscopic CSF leak repair was successful. Severe damage to the anterior intercavernous sinus can cause extensive exposure of the single-layered inner meningeal dura, where thinning might result in CSF exudation. Therefore, use of autologous tissues to cover and reinforce the severely damaged area of the anterior intercavernous sinus might help prevent postoperative CSF exudation.</p>","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":" ","pages":"111-115"},"PeriodicalIF":1.2,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141428332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Migraine-Like Headache with Aura Induced by a Small Infarct in the Parieto-Occipital Cortex: A Case Report. 顶枕叶皮层小梗塞诱发的偏头痛样先兆头痛:病例报告。
IF 1.2 4区 医学
Journal of Nippon Medical School Pub Date : 2025-03-07 Epub Date: 2024-06-18 DOI: 10.1272/jnms.JNMS.2025_92-103
Hiroyuki Hokama, Yuki Sakamoto, Serika Yamamoto, Mizuho Takahashi, Hiroto Kodera, Akihito Kutsuna, Yosuke Fujisawa, Chikako Nito, Kazumi Kimura
{"title":"Migraine-Like Headache with Aura Induced by a Small Infarct in the Parieto-Occipital Cortex: A Case Report.","authors":"Hiroyuki Hokama, Yuki Sakamoto, Serika Yamamoto, Mizuho Takahashi, Hiroto Kodera, Akihito Kutsuna, Yosuke Fujisawa, Chikako Nito, Kazumi Kimura","doi":"10.1272/jnms.JNMS.2025_92-103","DOIUrl":"10.1272/jnms.JNMS.2025_92-103","url":null,"abstract":"<p><p>A 56-year-old right-handed man was referred to our hospital for evaluation of sudden-onset transient quadrantanopia, which was followed by throbbing headache consistent with migraine with aura (MA). Magnetic resonance imaging (MRI) of the right parieto-occipital cortex on admission showed a hyperintense region on diffusion-weighted imaging, which disappeared 7 days later. A small cortical infarct in the parieto-occipital cortex can cause MA-like headache, and the present infarct lesion was only detectable on MRI during the acute phase. Performing MRI for patients with suspected acute MA might help identify the cause of MA-like headache and ensure appropriate management of patients.</p>","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":" ","pages":"116-119"},"PeriodicalIF":1.2,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141428336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pain in Soft Tissue Tumors: A Comprehensive Retrospective Study. 软组织肿瘤疼痛:一项全面的回顾性研究。
IF 1.2 4区 医学
Journal of Nippon Medical School Pub Date : 2025-01-01 DOI: 10.1272/jnms.JNMS.2025_92-113
Yasuyuki Kitagawa, Kazuma Miura, Daisuke Fukuhara, Naoto Kotani, Shoko Sasaki, Yosuke Shinozuka, Tokifumi Majima
{"title":"Pain in Soft Tissue Tumors: A Comprehensive Retrospective Study.","authors":"Yasuyuki Kitagawa, Kazuma Miura, Daisuke Fukuhara, Naoto Kotani, Shoko Sasaki, Yosuke Shinozuka, Tokifumi Majima","doi":"10.1272/jnms.JNMS.2025_92-113","DOIUrl":"10.1272/jnms.JNMS.2025_92-113","url":null,"abstract":"<p><strong>Background: </strong>In the field of orthopedics, few studies have examined pain associated with soft tissue tumors. To accurately and promptly diagnose soft tissue tumors and provide appropriate treatment, it is necessary to have a comprehensive understanding of the relationship between soft tissue tumors and pain.</p><p><strong>Methods: </strong>We analyzed data from patients with mass lesions in the extremities or trunk diagnosed by biopsy or surgery in our department and patients with ganglion cysts diagnosed by puncture between October 1, 2005, and September 30, 2011. Using medical records, we retrospectively investigated the clinical data.</p><p><strong>Results: </strong>Data from 473 patients with 482 lesions were analyzed. Pain was observed in 204 of the 482 lesions (42.3%). So-called painful tumors accounted for approximately half of the painful lesions (45.0%). Logistic regression indicated that pain was significantly associated with so-called painful tumors (odds ratio [OR]: 5.64; P < 0.001), inflammatory nodules (OR: 3.42; P = 0.007), and sites with strong physical stimulation (OR: 2.45; 95% confidence interval [CI]: 1.58-3.81; P < 0.001) but not with long diameter (OR: 0.90; P = 0.001) or malignancy (OR: 1.78; P = 0.144).</p><p><strong>Conclusion: </strong>Our findings suggest that so-called painful tumors account for approximately half of soft tissue mass lesions requiring surgery, biopsy, or puncture in orthopedics. It is thus important to have a clear understanding of such tumors. Inflammatory nodules are also important in the differential diagnosis of painful soft tissue lesions. Lesions at sites exposed to strong physical stimulation can cause pain.</p>","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":"92 1","pages":"80-87"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Virtual Monochromatic Imaging of Half-Iodine-Load, Contrast-Enhanced Computed Tomography with Deep Learning Image Reconstruction in Patients with Renal Insufficiency: A Clinical Pilot Study. 肾功能不全患者半碘负荷、对比度增强计算机断层扫描与深度学习图像重建的虚拟单色成像:一项临床试点研究。
IF 1.2 4区 医学
Journal of Nippon Medical School Pub Date : 2025-01-01 DOI: 10.1272/jnms.JNMS.2025_92-112
Shingo Harashima, Rika Fukui, Wakana Samejima, Yuta Hirose, Toshiya Kariyasu, Makiko Nishikawa, Hidenori Yamaguchi, Haruhiko Machida
{"title":"Virtual Monochromatic Imaging of Half-Iodine-Load, Contrast-Enhanced Computed Tomography with Deep Learning Image Reconstruction in Patients with Renal Insufficiency: A Clinical Pilot Study.","authors":"Shingo Harashima, Rika Fukui, Wakana Samejima, Yuta Hirose, Toshiya Kariyasu, Makiko Nishikawa, Hidenori Yamaguchi, Haruhiko Machida","doi":"10.1272/jnms.JNMS.2025_92-112","DOIUrl":"10.1272/jnms.JNMS.2025_92-112","url":null,"abstract":"<p><strong>Background: </strong>We retrospectively examined image quality (IQ) of thin-slice virtual monochromatic imaging (VMI) of half-iodine-load, abdominopelvic, contrast-enhanced CT (CECT) by dual-energy CT (DECT) with deep learning image reconstruction (DLIR).</p><p><strong>Methods: </strong>In 28 oncology patients with moderate-to-severe renal impairment undergoing half-iodine-load (300 mgI/kg) CECT by DECT during the nephrographic phase, we reconstructed VMI at 40-70 keV with a slice thickness of 0.625 mm using filtered back-projection (FBP), hybrid iterative reconstruction (HIR), and DLIR; measured contrast-noise ratio (CNR) of the liver, spleen, aorta, portal vein, and prostate/uterus; and determined the optimal keV to achieve the maximal CNR. At the optimal keV, two independent radiologists compared each organ's CNR and subjective IQ scores among FBP, HIR, and DLIR to subjectively grade image noise, contrast, sharpness, delineation of small structures, and overall IQ.</p><p><strong>Results: </strong>CNR of each organ increased continuously from 70 to 40 keV using FBP, HIR, and DLIR. At 40 keV, CNR of the prostate/uterus was significantly higher with DLIR than with FBP; however, CNR was similar between FBP and HIR and between HIR and DLIR. The CNR of all other organs increased significantly from FBP to HIR to DLIR (P < 0.05). All IQ scores significantly improved from FBP to HIR to DLIR (P < 0.05) and were acceptable in all patients with DLIR only.</p><p><strong>Conclusions: </strong>The combination of 40 keV and DLIR offers the maximal CNR and a subjectively acceptable IQ for thin-slice VMI of half-iodine-load CECT.</p>","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":"92 1","pages":"69-79"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effects of Biologics on Fibrosis-4 Index in Patients with Psoriasis. 生物制剂对银屑病患者纤维化-4指数的影响。
IF 1.2 4区 医学
Journal of Nippon Medical School Pub Date : 2025-01-01 DOI: 10.1272/jnms.JNMS.2025_92-114
Takashi Morita, Susumu Ichiyama, Michiko Ito, Saeko Ozaki, Taeang Arai, Masanori Atsukawa, Katsuhiko Iwakiri, Teppei Hagino, Toshihiko Hoashi, Naoko Kanda, Hidehisa Saeki
{"title":"Effects of Biologics on Fibrosis-4 Index in Patients with Psoriasis.","authors":"Takashi Morita, Susumu Ichiyama, Michiko Ito, Saeko Ozaki, Taeang Arai, Masanori Atsukawa, Katsuhiko Iwakiri, Teppei Hagino, Toshihiko Hoashi, Naoko Kanda, Hidehisa Saeki","doi":"10.1272/jnms.JNMS.2025_92-114","DOIUrl":"10.1272/jnms.JNMS.2025_92-114","url":null,"abstract":"<p><strong>Background: </strong>Psoriasis is accompanied by systemic inflammation that includes the liver. The fibrosis-4 (FIB-4) index was developed to predict significant liver fibrosis. The present study evaluated the effects of biologics, including TNF inhibitors, on the FIB-4 index in psoriasis patients.</p><p><strong>Methods: </strong>All adult patients with psoriasis who were prescribed biologics (TNF inhibitors, IL-17 inhibitors, or IL-23 inhibitors) at Nippon Medical School from June 2014 to January 2024 for the first time (biologic-naïve patients) were included in this study. The FIB-4 index was calculated before and after 6 months of treatment with biologics.</p><p><strong>Results: </strong>A total of 105 patients were enrolled. The FIB-4 index was higher after 6 months of treatment with TNF inhibitors (P=0.0018) and IL-17 inhibitors (P=0.045) but did not change with IL-23 inhibitors. Aspartate aminotransferase and alanine aminotransferase levels did not change after treatment with TNF inhibitors, IL-17 inhibitors, or IL-23 inhibitors. Platelet count decreased after treatment with TNF inhibitors (P=0.0011) and IL-23 inhibitors (P=0.039) but did not change with IL-17 inhibitors.</p><p><strong>Conclusions: </strong>Downregulation of platelets seems to be a major contributing factor for the increase in FIB-4 index in patients treated with TNF inhibitors. Although the FIB-4 index is a simple marker to screen for liver fibrosis, changes in this index should be interpreted with caution, and imaging findings such as transient elastography should also be used to evaluate the status of liver fibrosis.</p>","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":"92 1","pages":"88-96"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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